BILL NUMBER: SB 1266 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY JUNE 17, 2014
AMENDED IN SENATE MAY 27, 2014
AMENDED IN SENATE MAY 6, 2014
AMENDED IN SENATE APRIL 21, 2014
AMENDED IN SENATE MARCH 24, 2014
INTRODUCED BY Senator Huff
(Coauthor: Senator Hill)
FEBRUARY 21, 2014
An act to amend Section 4119.2 of the Business and Professions
Code, and to amend Section 49414 of the Education Code, relating to
pupil health.
LEGISLATIVE COUNSEL'S DIGEST
SB 1266, as amended, Huff. Pupil health: epinephrine
auto-injectors.
Existing
(1) Existing law authorizes a
school district or county office of education to provide emergency
epinephrine auto-injectors to trained personnel, and authorizes
trained personnel to use those epinephrine
auto-injectors to provide emergency medical aid to persons suffering
from an anaphylactic reaction. Existing law authorizes each public
and private elementary and secondary school in the state to designate
one or more school personnel on a voluntary basis to receive initial
and annual refresher training regarding the storage and emergency
use of an epinephrine auto-injector, as specified. Existing law
authorizes a school nurse, or a person who has received the training
described above if the school does not have a school nurse, to, among
other things, obtain a prescription for epinephrine
auto-injectors, as specified. Existing law authorizes a pharmacy to
furnish epinephrine auto-injectors to a school district or county
office of education if certain requirements are met.
auto-injectors.
This bill would instead require school districts,
county offices of education, and charter schools to provide emergency
epinephrine auto-injectors to school nurses and trained
personnel who have volunteered, as specified, and would authorize
student nurses and trained personnel to use those
epinephrine auto-injectors to provide emergency medical
aid to persons suffering, or reasonably believed to be suffering,
from an anaphylactic reaction. The bill would require
school districts, county offices of education, and charter schools to
distribute a notice requesting volunteers at least once a year.
The bill would require a school nurse,
nurse or , if the school has a volunteer, a school
administrator if an employee has volunteered, as specified,
and the school does not have a school nurse or the school nurse is
not onsite or available, administrator to obtain
the prescription for epinephrine auto-injectors, as
specified, and would authorize the prescription
for epinephrine auto-injectors to be filled by local or
mail order pharmacies or epinephrine auto-injector manufacturers.
The bill would authorize a pharmacy to also furnish
epinephrine auto-injectors to a charter school if certain conditions
are met. The bill would require an
epinephrine auto-injector auto-injectors
to be restocked as soon as possible after it is used
and before its expiration date. by the school nurse or
school administrator, or the school district or county office of
education on behalf of a school nurse or school administrator of any
school in the school district or county, or by a charter operator on
behalf of charter schools in accordance with specified provisions. By
imposing additional duties on local educational agencies, the bill
would impose a state-mandated local program.
(2) Existing law requires the Superintendent of Public Instruction
to establish minimum standards of training for the administration of
epinephrine auto-injectors, as specified, and requires a school
district or county of office of education to create a plan relating
to their use.
The
This bill would revise the training requirements, and would
require the Superintendent to review the minimum standards of
training at least every 5 years. The bill would
require the school nurse or voluntarily designated employee to report
any incident of epinephrine auto-injector use to the school
district, county office of education, or chartering authority on a
form developed by the State Department of Education within 30 days
after the last day of each school year. The bill would require the
school district, county office of education, or chartering authority
to report any incident of epinephrine auto-injector use to the
department on those forms. delete the requirement for
creating a plan, and would impose specified reporting requirements
relating to the use of epinephrine auto-injectors on specified school
employees, local educational agencies, and the State Department of
Education. The bill would require a school district, county
office of education, or charter school to ensure that each employee
who volunteers is provided defense and indemnification by the school
district, county office of education, or charter school for any and
all civil liability, as specified. The bill would authorize a
state agency, the State Department of E ducation, or a
public school to accept gifts, grants, and donations from any
source for the support of the public school carrying out these
provisions.
By provisions. By requiring local
educational agencies to perform additional duties related to
epinephrine auto-injectors, the bill would impose a state-mandated
local program.
(3) Existing law authorizes a pharmacy to furnish epinephrine
auto-injectors to a school district or county office of education if
certain requirements are met.
This bill would also authorize a pharmacy to furnish epinephrine
auto-injectors to charter schools pursuant to those provisions.
The
(4) The California Constitution
requires the state to reimburse local agencies and school districts
for certain costs mandated by the state. Statutory provisions
establish procedures for making that reimbursement.
This bill would provide that, if the Commission on State Mandates
determines that the bill contains costs mandated by the state,
reimbursement for those costs shall be made pursuant to these
statutory provisions.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 4119.2 of the Business and Professions Code is
amended to read:
4119.2. (a) Notwithstanding any other law, a pharmacy may furnish
epinephrine auto-injectors to a school district, county office of
education, or charter school pursuant to Section 49414 of the
Education Code if all of the following are met:
(1) The epinephrine auto-injectors are furnished exclusively for
use at a school district site, county office of education, or charter
school.
(2) A physician and surgeon provides a written order that
specifies the quantity of epinephrine auto-injectors to be furnished.
(b) Records regarding the acquisition and disposition of
epinephrine auto-injectors furnished pursuant to subdivision (a)
shall be maintained by the school district, county office of
education, or charter school for a period of three years from the
date the records were created. The school district, county office of
education, or charter school shall be responsible for monitoring the
supply of epinephrine auto-injectors and ensuring the destruction of
expired epinephrine auto-injectors.
SEC. 2. Section 49414 of the Education Code is amended to read:
49414. (a) School districts, county offices of education, and
charter schools shall provide emergency epinephrine auto-injectors to
school nurses or trained personnel who have volunteered
pursuant to subdivision (d), and school nurses or trained
personnel may use those epinephrine auto-injectors
to provide emergency medical aid to persons suffering, or reasonably
believed to be suffering, from an anaphylactic reaction.
(b) For purposes of this section, the following terms have the
following meanings:
(1) "Anaphylaxis" means a potentially life-threatening
hypersensitivity to a substance.
(A) Symptoms of anaphylaxis may include shortness of breath,
wheezing, difficulty breathing, difficulty talking or swallowing,
hives, itching, swelling, shock, or asthma.
(B) Causes of anaphylaxis may include, but are not limited to, an
insect sting, food allergy, drug reaction, and exercise.
(2) "Epinephrine auto-injector" means a disposable drug delivery
system with a spring-activated needle that is designed for emergency
administration of epinephrine to provide rapid, convenient first aid
for persons suffering a potentially fatal reaction to anaphylaxis.
(3) "Volunteer" or "trained personnel" means an employee who has
volunteered to administer epinephrine auto-injectors to a person if
the person is suffering, or reasonably believed to be suffering, from
anaphylaxis, and has been designated by a school and has received
training pursuant to subdivision (d).
(c) Each private elementary and secondary school in the state may
voluntarily determine whether or not to make emergency epinephrine
auto-injectors and trained personnel available at its school. In
making this determination, a school shall evaluate the emergency
medical response time to the school and determine whether initiating
emergency medical services is an acceptable alternative to
epinephrine auto-injectors and trained personnel. A private
elementary or secondary school choosing to exercise the authority
provided under this subdivision shall not receive state funds
specifically for purposes of this subdivision.
(d) Each public and private elementary and secondary school in the
state may designate one or more school personnel on a
voluntary basis volunteers to receive initial
and annual refresher training, based on the standards developed
pursuant to subdivision (e), regarding the storage and emergency use
of an epinephrine auto-injector from the school nurse or other
qualified person designated by the physician and surgeon
employed by or contracting with the local educational
agency physician, agency, the medical director
of the local health department, or the local emergency medical
services director.
(e) (1) Every five years, or sooner as deemed necessary by the
Superintendent, the Superintendent shall review minimum standards of
training for the administration of epinephrine auto-injectors that
satisfy the requirements of paragraph (2). For purposes of this
subdivision, the Superintendent shall consult with organizations and
providers with expertise in administering epinephrine auto-injectors
and administering medication in a school environment, including, but
not limited to, the State Department of Public Health, the Emergency
Medical Services Authority, the American Academy of Allergy, Asthma
and Immunology, the California School Nurses Organization, the
California Medical Association, the American Academy of Pediatrics,
Food Allergy Research and Education, the California Society of
Allergy, Asthma and Immunology, the American College of Allergy,
Asthma and Immunology, and others.
(2) Training established pursuant to this subdivision shall
include all of the following:
(A) Techniques for recognizing symptoms of anaphylaxis.
(B) Standards and procedures for the storage, restocking, and
emergency use of epinephrine auto-injectors.
(C) Emergency followup procedures, including calling the emergency
911 telephone number and contacting, if possible, the pupil's parent
and physician.
(D) Instruction Recommendation on the
necessity of instruction and certification in cardiopulmonary
resuscitation.
(E) Instruction on how to determine whether to use an adult
epinephrine auto-injector or a junior epinephrine
auto-injector. auto-injector, which shall include
consideration of a pupil's grade level or age as a guideline of
equivalency for the appropriate pupil weight determination.
(F) Written materials covering the information required under this
subdivision.
(3) Training established pursuant to this subdivision shall be
consistent with the most recent Voluntary Guidelines for Managing
Food Allergies In Schools and Early Care and Education Programs
published by the federal Centers for Disease Control and Prevention
and the most recent guidelines for medication administration issued
by the department.
(4) A school shall retain for reference the written materials
prepared under subparagraph (F) of paragraph (2).
(f) A school district, county office of education, or charter
school shall distribute a notice at least once per school year to all
staff that contains the following information:
(1) A description of the volunteer request stating that the
request is for volunteers to be trained to administer an epinephrine
auto-injector to a person if the person is suffering, or reasonably
believed to be suffering, from anaphylaxis, as specified in
subdivision (b).
(2) A description of the training that the volunteer will receive
pursuant to subdivision (d).
(f)
(g) (1) A school nurse
or, if the school does not have a school nurse or the
nurse, if the school nurse is not onsite or
available, a school administrator if an employee has
volunteered pursuant to subdivision (d), shall obtain from
the local educational agency physician, a
physician and surgeon employed by or contracting with the
local educational agency, the medical director of the local health
department, or the local emergency medical services director a
prescription for epinephrine auto-injectors that, at a minimum,
includes, for elementary schools, one regular epinephrine
auto-injector and one junior epinephrine auto-injector, and for
junior high or middle schools and high schools, if there are no
pupils who require a junior epinephrine auto-injector, one regular
epinephrine auto-injector. The prescription may be filled by
local or mail order pharmacies or epinephrine auto-injector
manufacturers. The school nurse shall be responsible
for stocking and restocking epinephrine auto-injectors in accordance
with this section.
(2) If a school nurse is not onsite or available and the school
has a volunteer, the school administrator shall obtain from a
physician and surgeon employed by or contracting with the local
educational agency, the medical director of the local health
department, or the local emergency medical services director a
prescription for epinephrine auto-injectors that, at a minimum,
includes, for elementary schools, one regular epinephrine
auto-injector and one junior epinephrine auto-injector, and for
junior high or middle schools and high schools, if there are no
pupils who require a junior epinephrine auto-injector, one regular
epinephrine auto-injector. The school administrator shall be
responsible for stocking and restocking the epinephrine
auto-injectors in accordance with this section.
(3) Notwithstanding paragraphs (1) and (2), a school district or
county office of education, on behalf of the school nurse or school
administrator of any school, in that school district or county, may
obtain the prescriptions for epinephrine auto-injectors required in
paragraphs (1) and (2), and a charter operator, on behalf of he
school nurse or school administrator of any charter school in the
school district or county, may obtain the prescriptions for
epinephrine auto-injectors required in paragraphs (1) and (2). The
school district or county office of education, or, for a charter
school, the charter operator, may stock and restock the epinephrine
auto-injectors in accordance with the requirements specified in
paragraphs (1) and (2).
(4) A prescription pursuant to this subdivision may be filled by
local or mail order pharmacies or epinephrine auto-injector
manufacturers.
(g)
(h) A school nurse, or if the school does not have a
school nurse or the school nurse is not onsite or available, a
volunteer designee who has received training pursuant to
subdivision (d), volunteer, may administer an
epinephrine auto-injector to a person exhibiting potentially
life-threatening symptoms of anaphylaxis at school or a school
activity when a physician is not immediately available. If the
epinephrine auto-injector is used it shall be restocked as soon as
reasonably possible. possible, but no later
than two weeks after it is used. Epinephrine auto-injectors
shall be restocked before their expiration date.
(h)
(i) A person who has received training as set
forth in subdivision (d) volunteer shall
initiate emergency medical services or other appropriate medical
followup in accordance with the training materials retained pursuant
to paragraph (4) of subdivision (e).
(i) No later than 30 days after the last day of each school year,
the school nurse or voluntarily designated employee shall report any
incident of epinephrine auto-injector use to the school district,
county office of education, or chartering authority on a form
developed by the department. The school district, county office of
education, or chartering authority shall report any incident of
epinephrine auto-injector use to the department on the form developed
by the department.
(j) No later than 72 hours after an incident of epinephrine
auto-injector use, the school nurse or the volunteer, in conjunction
with the school administrator, shall report the incident to the
school district, county office of education, or chartering authority
on a form developed by the department in conjunction with the
California School Nurses Organization, the California Emergency
Medical Services Authority, and the American Academy of Pediatrics.
The school district, county office of education, or chartering
authority shall report the data using the California Longitudinal
Pupil Achievement Data System. The department shall annually publish
a summary of the data on its Internet Web site.
(j)
(k) A school district, county office of education, or
charter school shall ensure that each employee who volunteers under
this section will be provided defense and indemnification by the
school district, county office of education, or charter school for
any and all civil liability, in accordance with, but not limited to,
that provided in Division 3.6 (commencing with Section 810) of Title
1 of the Government Code. This information shall be reduced to
writing, provided to the volunteer, and retained in the volunteer's
personnel file.
(k)
(l) A state agency, the department, or a
public school may accept gifts, grants, and donations from any source
for the support of the public school carrying out the provisions of
this section, including, but not limited to, the acceptance of
epinephrine auto-injectors from a manufacturer or wholesaler.
SEC. 3. If the Commission on State Mandates determines that this
act contains costs mandated by the state, reimbursement to local
agencies and school districts for those costs shall be made pursuant
to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of
the Government Code.